Acute tubular necrosis

Question 1

What is acute tubular necrosis?

Answer 1

Damage/death to the epithelial cells of the renal tubules

Due to ischaemia or toxins

Question 2

What is acute tubular necrosis the most common cause of?

Answer 2

AKI

Question 3

Reversibility of acute tubular necrosis?

Answer 3

Epithelial cells have ability to regenerate - making it reversible

Recovery usually takes 7–21 days

Question 4

Causes of acute tubular necrosis:

Answer 4

Ischaemia - secondary to hypoperfusion in:

• Shock
• Sepsis
• Dehydration

Direct damage from toxins such as:

• Radiology contrast dye
• Gentamycin
• NSAIDs

Question 5

Findings on urinalysis:

Answer 5

’ muddy brown cases’
- finding specific to acute tubular necrosis

Also can be renal tubular epithelial cells in the urine

Question 6

Management of acute tubular necrosis:

Answer 6

Same as with other causes of AKI:

• Supportive management
• IV fluids
• Stopping nephrotoxic medications
• Treating complications